Student health evaluation information sheet

BINGHAMTON UNIVERSITY DECKER SCHOOL OF NURSING
Student Health Requirements
This document includes information regarding:
• Student health evaluation form
• Documentation of immunity to communicable diseases
• Student health insurance requirement
• CPR certification requirement
• HIPAA, OSHA bloodborne pathogens and infection control training
Decker School of Nursing (DSON) students enrolling in clinical nursing courses this fall need to
comply with the New York State Department of Health regulation that mandates annual physical
examinations and documented evidence of immunity to several communicable diseases for all
healthcare providers, as well as additional requirements of the school and selected healthcare
agencies. Students will need to complete the DSON Student Health Evaluation form, which
includes the Physical Examination and Student Immunization Record.
Health requirements are current for one rolling calendar year (meaning they expire one year to
the date they were completed). Any students who fulfill these requirements early in the spring
will need to repeat the requirements within the academic year to maintain current health
requirement status.
Students registering in clinical nursing courses will also be required to submit evidence of
current, personal health insurance coverage and proof of CPR certification at a level comparable
to “CPR for the Professional Rescuer” and including AED (defibrillator) training through the
American Heart Association, American Red Cross or American Health Safety Institute. The
course must have a hands-on component; purely online courses will not be accepted. The DSON
accepts only professional provider courses from the American Heart Association, American Red
Cross or American Safety and Health Institute.
Health requirements are managed through Castle Branch (castlebranch.com). All requirements
can be uploaded, faxed or mailed to Castle Branch. The DSON will not accept emailed or faxed
copies of health documents. See the enclosed instructions to start a profile and begin completing
the requirements.
The deadline for submission of health requirements for the following programs are:
Baccalaureate Accelerated Track (BAT) students — May 1
• Traditional students (transfers, juniors and seniors) — July 1
• RN-to-BS and graduate students — August 1
SERVICES AVAILABLE AT BINGHAMTON UNIVERSITY’S DECKER STUDENT HEALTH SERVICES
CENTER
Many services for students registered in classes at Binghamton University are available at the
Decker Student Health Services Center (this is the University’s health clinic and isn’t part of the
DSON), including those listed below. For more information about services provided, visit the
center’s website at binghamton.edu/health or call 607-777-2221.
1. Mantoux tuberculin tests and immunizations
2. Tetanus, MMR, meningitis, varicella and hepatitis B vaccines
3. Laboratory tests for the measles, mumps, rubella and varicella titers (titers are laboratory
tests that measure the level of antibodies to the disease present in the blood)
• When classes are in session, lab tests are available at the Decker Student Health Services
Center Monday through Friday, 9:30–10:30 a.m.
• When classes aren’t in session, students will be given a requisition by Decker Student
Health Services Center staff and directed to the proper off-campus laboratory location
DETAILED INFORMATION REGARDING DSON STUDENT HEALTH EVALUATION FORM AND
OTHER HEALTH REQUIREMENTS
Binghamton University’s student health requirements (for students new to the University)
If you will be entering Binghamton University for the first time in the summer or fall, you are
required by the University to submit medical history and immunization forms to the Decker
Student Health Services Center (this is a University office and not the same as the DSON). Visit
binghamton.edu/health/new-students.html for information and instructions on completing the
University health requirements.
You must also have your healthcare provider complete the DSON Student Health Evaluation
form (posted on this DSON webpage: binghamton.edu/dson/undergrad/clinical_req.html).
Be sure to upload a copy to your Castle Branch account. Healthcare institutions where you will
be performing clinical will require this information.
Be sure that all sections of all forms
(binghamton.edu/dson/undergrad/pdf/clinical_req.html#forms) are accepted and completed.
Incomplete and illegible forms will be rejected. Rejected or missing health documents will delay
your course registration and can affect your clinical time.
Copies of physical examinations will not be accepted. You must have your healthcare provider
complete the DSON Student Health Evaluation form.
Student health (HIPAA) release form
Some clinical agencies used by the DSON require specific student health data for participation in
clinical experiences. This information may include the physical examination date, immunization
dates, titer reports, Mantoux test or chest X-ray dates and results, and/or a copy of the Physical
Examination and Student Immunization Record (contained on your DSON Student Health
Evaluation form). You will be asked to sign a release form
(binghamton.edu/dson/undergrad/pdf/clinical_req/DSON%20Health%20Release.pdf), so this
information may be forwarded to assigned clinical agencies. Print, sign, date and upload the form
to your Castle Branch account.
Immunizations
Be sure all information provided on your immunization record is legible. (You may provide
immunization records from your healthcare provider or have your healthcare provider complete
the Student Immunization Record portion of the DSON Student Health Evaluation form — both
are acceptable proof of your immunizations.)
•
Tetanus: All students must have had one dose of diphtheria-tetanus toxoid vaccine within the
past 10 years. The Centers for Disease Control recommend that healthcare personnel receive
a one-time dose of Tdap. This should be considered now that students will be entering
healthcare facilities. Have your provider indicate (circle on form) which combination of the
immunization you received.
•
Measles, Mumps, Rubella: You must provide either documentation of receiving two MMR
immunizations (month, date and year) after the age of 12 months OR proof of serologic
immunity to the communicable diseases (titers). If submitting a titer, upload titer (lab)
results.
•
Varicella (chickenpox): You must provide documentation of receiving two varicella
immunizations (month, date and year) OR a positive titer (upload lab results) OR diagnosis
of history of varicella disease by a healthcare provider (month, date and year disease was
acquired). Students who can provide proof of two varicella immunizations are not required to
have a titer drawn. Students who are not immune to varicella are at risk for contracting the
disease and participation as well as progress in clinical nursing courses will cease until the
student is re-immunized. Students who have a negative varicella titer are instructed to obtain
the varicella immunizations. The varicella vaccine is given in a series of two doses four to
eight weeks apart. Students may obtain this immunization through their healthcare provider
or at the Decker Student Health Services Center.
•
Hepatitis B: The DSON has adopted Centers for Disease Control recommendations regarding
hepatitis B immunizations, which state nursing students should receive the hepatitis B series.
You must provide proof of receiving the series (3) OR proof you are in the process of
receiving the series OR a signed declination form (you will indicate you are declining on
Castle Branch).
•
Mantoux tuberculin test (PPD): Clinical agencies used by the DSON require a two-step
Mantoux tuberculin test. The two-step process involves the student having a second
tuberculin test no less than one week after the initial tuberculosis test OR providing proof of
two negative tests within 12 months. Either scenario must involve providing proof of two
tuberculin tests placed within the current rolling calendar year.
o If the tuberculin test is positive, a chest X-ray or Quantiferon Gold blood test must be
completed. The chest X-ray report must be submitted to the DSON via your Castle
Branch account. Students who have a chest x-ray or Quantiferon Gold test must complete
a TB Symptom Screening form annually
(binghamton.edu/dson/undergrad/pdf/clinical_req/PPD%20Screening.pdf).
Health insurance
DSON students must provide proof of current, personal health insurance coverage. Evidence of
this coverage may take the form of a letter from the insurance company, a letter from the
employer where the insurance coverage is an employee benefit, or a copy of the front and back
of a health insurance card. The documentation (letter or card) you provide as proof of insurance
must include your name. If your name is not listed on the insurance card, also provide a letter or
document from your insurer that includes your name and states you are covered under the policy.
Binghamton University offers a student health insurance plan. The University’s Student
Accounts Office can provide a brochure describing this plan and information regarding the
premium for the academic year. Contact Student Accounts at 607-777-2702 or
binghamton.edu/student-accounts. Students enrolling in this plan will have the premium added to
their tuition and fees bill each semester.
CPR
You must provide proof of current certification from either the American Red Cross/Professional
Rescuer or American Heart Association/Healthcare Provider or the American Safety and Health
Institute CPR/PRO. The course must include adult, pediatric and infant CPR and obstructed
airway, ambu-mask devices and AED. There must be a hands-on component to the course;
DSON does not accept online CPR certifications Be certain to submit the front and back of your
signed CPR card to Castle Branch.
NOTE: The only courses we accept for CPR certification are: the American Red
Cross/Professional Rescuer, American Heart Association/Healthcare Provider or American
Safety and Health Institute CPR/PRO.
Confidentiality agreement
All students are required to sign a DSON Confidentiality Agreement each year. Upload the
document
(binghamton.edu/dson/undergrad/pdf/clinical_req/DSON%20Confidentiality%20Statement.pdf
) to your Castle Branch profile.
HIPAA/OSHA bloodborne pathogens/infection control training
HIPAA, OSHA bloodborne pathogens standard and mandatory infection control training will be
provided for undergraduate students as part of their DSON program. RN students who can
provide documentation of this requirement from their employers may be excused from the inhouse training. Graduate students must provide proof of completion of the programs and submit
to Castle Branch annually.
Criminal background check
Many of the agencies we use for clinical placements require criminal background checks for all
students who come into the agency. The extent of the investigation varies by facility, with some
requiring more extensive federal clearances and fingerprints. To comply with their requirements,
DSON requires all student to complete a criminal background check. Complete the online
Pennsylvania Criminal Record Check at psp.pa.gov/Pages/Request-a-Criminal-HistoryRecord.aspx (select volunteer.FREE) then upload the certificate to your Castle Branch account.
Child abuse clearance
Some Pennsylvania agencies we use for clinical placements require students to have
Pennsylvania Child Abuse History Clearance. For that reason, DSON requires all students to
complete the online application through Castle Branch. Once completed, you will receive a
certificate that you will upload to your Castle Branch profile.
Flu Vaccine
All students are to receive a flu vaccine annually. To prove you received your annual vaccine,
create a document that includes the following: your name; the location you received the vaccine;
the date you received the vaccine; the name of the individual who administered the vaccine;
which arm you received the vaccination in; and the vaccine name, manufacturer, lot # and
expiration date. Upload this document to your Castle Branch account by October 1 each year.
Castle Branch Medical Document Manager
All health requirements must be submitted to the Castle Branch Medical Document Manager
within castlebranch.com. All documents must be uploaded to your Castle Branch profile; the
DSON does not accept paper, email or faxed copies. Instructions on creating a Castle Branch
account are located on the DSON clinical requirements webpage
(binghamton.edu/dson/undergrad/clinical_req.html#document).
QUESTIONS?
Questions regarding any of the information above may be directed to DSON Clinical Instructor
Michele Steinhauser, RN, MS, at 607-240-3977 or [email protected].
03/17